REBOA Improves Outcomes in Hybrid Surgery for Ruptured Abdominal Aortic Aneurysms

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Emergency Medicine

Background:

• High mortality rates persist for ruptured abdominal aortic aneurysm (rAAA) despite advancements.
• Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers temporary bleeding control.
• The study evaluates REBOA's impact on open aortic surgery for rAAA.

Purpose of the Study:

• To compare the outcomes of open aortic surgery for rAAA with and without REBOA.
• To assess the effect of REBOA on mortality, hospital stay, and complications.

Main Methods:

• Retrospective analysis of 53 consecutive rAAA patients undergoing open surgery (2014-2021).
• Patients divided into REBOA (21) and non-REBOA (32) groups.
• Primary outcomes: 24-hour and 30-day mortality; Secondary outcomes: ICU/in-hospital stay, bleeding, renal failure, bowel ischemia, TIA/stroke.

Main Results:

• REBOA group showed significantly lower 24-hr (9.5% vs. 37.5%) and 30-day mortality (14.2% vs. 43.7%).
• Shorter ICU (2.42 vs. 5.09 days) and in-hospital stays (12.8 vs. 15.6 days) in the REBOA group.
• Reduced procedure time and bleeding with REBOA; no significant difference in major complications.

Conclusions:

• REBOA significantly improves survival rates in rAAA open surgery compared to non-REBOA.
• REBOA is a less invasive option, comparable to traditional open aortic cross-clamping.
• REBOA may be a valuable first-line treatment for rAAA open surgery, especially when endovascular repair is unsuitable.